<form class="layui-form" action="">
	<input name="id" id="id" type="hidden" value="{$info.id}">
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">商家名称：</label>
			<div class="layui-input-inline">
				<input name="company_name" id="company_name" value="{$info.company_name}" lay-verify="required" autocomplete="off" placeholder="请输入商家名称" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">纳税编号：</label>
			<div class="layui-input-inline">
				<input name="taxpayer_number" id="taxpayer_number" value="{$info.taxpayer_number}" lay-verify="required" placeholder="请输入纳税编号" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">销售总额：</label>
			<div class="layui-input-inline">
				<input name="seller_amount" id="seller_amount" value="{$info.seller_amount}" lay-verify="required" autocomplete="off" placeholder="请输入销售总额" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">待结余额：</label>
			<div class="layui-input-inline">
				<input name="balance" id="balance" value="{$info.balance}" lay-verify="required" placeholder="请输入待结算余额" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">注册地址：</label>
			<div class="layui-input-inline">
				<input name="invoice_address" id="invoice_address" value="{$info.invoice_address}" lay-verify="required" autocomplete="off" placeholder="请输入注册地址" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">注册电话：</label>
			<div class="layui-input-inline">
				<input name="invoice_tel" id="invoice_tel" value="{$info.invoice_tel}" lay-verify="required" placeholder="请输入注册电话" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">开户银行：</label>
			<div class="layui-input-inline">
				<input name="invoice_bank" id="invoice_bank" value="{$info.invoice_bank}" lay-verify="required" autocomplete="off" placeholder="请输入开户银行" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">开户账号：</label>
			<div class="layui-input-inline">
				<input name="invoice_bank_account" id="invoice_bank_account" value="{$info.invoice_bank_account}" lay-verify="required" placeholder="请输入开户账号" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">销售目标：</label>
			<div class="layui-input-inline">
				<input name="seller_target" id="seller_target" value="{$info.seller_target}" lay-verify="required" autocomplete="off" placeholder="请输入销售目标" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">联系电话：</label>
			<div class="layui-input-inline">
				<input name="contact_tel" id="contact_tel" value="{$info.contact_tel}" lay-verify="required" placeholder="请输入联系电话" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">所在城市：</label>
		{:W('city/select',array($info['district_id'],3))}
	</div>
	<div class="layui-form-item" style="width:625px;">
		<label class="layui-form-label">详细地址：</label>
		<div class="layui-input-block">
			<input name="address" id="address" value="{$info.address}" lay-verify="required" autocomplete="off" placeholder="请输入详细地址" class="layui-input" type="text">
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">审核状态：</label>
			<div class="layui-input-inline">
				{:W('common/singleSelect',array('check_status|1|审核状态|name|id',C('CHECK_STATUS_ARR'),$info['check_status']))}
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">状态：</label>
			<div class="layui-input-inline">
				{:W('common/switchCheck',array(status,'在用|停用',$info['status']))}
			</div>
		</div>
	</div>
	<div class="layui-form-item layui-form-text" style="width:625px;">
		<label class="layui-form-label">备注：</label>
		<div class="layui-input-block">
			<textarea name="remark" id="remark" placeholder="请输入备注" class="layui-textarea">{$info.remark}</textarea>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-input-block">
			<button class="layui-btn" lay-submit="" lay-filter="submitForm" id="submitForm">立即提交</button>
			<button type="reset" class="layui-btn layui-btn-primary">重置</button>
		</div>
	</div>
</form>